Diagnosis
Name two diagnoses classified as anxiety disorders in the DSM 5.
What are: GAD, Social Anxiety, Panic Disorder, Specific Phobia
Specific fear that is so strong a person goes to extreme measures to avoid it.
What is Specific Phobia?
A 25 year old female comes to her PCP with muscle tension, decreased sleep, fatigue, and poor concentration. She has been a "worrier" her whole life. She denies any history of substance abuse and is medically healthy. What is your initial diagnostic impression?
What is Generalized Anxiety Disorder?
A 19 year old male presents to the Emergency Dept. with audio and visual hallucinations. His mother says this has been going on for about six months. His labs come back positive for methamphetamines. What are the two most likely possible diagnoses?
What are amphetamine induced psychosis and psychotic disorder unspecified?
This law protects Personal Health Information specific to substance use treatment records.
What is 42 CFR Part 2?
What diagnosis is best described by low energy, fatigue, sleep disturbance, poor concentration, and hopelessness that last for two or more years?
What is Dysthymic Disorder?
Name two of the three main symptoms of ADHD.
What are: Inattention; Hyperactivity; Impulsivity?
A 29 year old female presents to the walk in clinic with sad mood, sleep disturbance, anhedonia, and social isolation. After a bit, she discloses a sexual assault by a close friend a few months ago, but is visibly uncomfortable talking about it and keeps trying to change the subject and is fiercely opposed to reporting this incident to the police. She tells you she is having nightmares, has a general fear for her personal safety, and feels like she will never be able to be intimate with another person again. What is your initial diagnostic impression?
What is PTSD?
A 79 year old male presents to the Emergency Dept. with symptoms of heart palpitations, hyper-ventilation, dizziness, confusion, sweating, and disorganized thoughts. What do you want to ask the attending physician to rule out?
What are: dementia; stroke; UTI
According to Maslow, this level in the hierarchy of needs represents the most basic needs.
What is Physiological?
What is a key difference between Bipolar I and Bipolar II?
There is a high correlation between Emergency Dept. utilization and this:
What is a Severe and Persistent Mental Illness?
A 22-year-old male comes to the campus health center at the request of his academic advisor. He has begun missing significant days of class and is at high risk of academic probation. He reports that he is afraid of drawing attention to himself in his classes by asking "stupid questions" and has avoided meeting with his professors and teaching assistants. He experiences particular difficulty in seminars and tutorials, where there is less opportunity to be inconspicuous than in a lecture theater. He feels his mouth getting dry and his heart racing when even thinking about trying to get help. What is your initial diagnostic impression?
What is Social Anxiety?
What are: hypertension; heart problems; keep problems; anxiety problems
According to SAMHSA, 5.1 million young adults reported having a substance use disorder in 2018. What percentage of that population did not receive treatment?
a)13% c)87%
b) 74% d) 42%
What is c) 87%?
A 38-year-old divorced female seeks services for depression, though she says she is well-established in her career and has several close friends with whom she enjoys spending time. She also shares that she experienced a sexual assault in high school. During your conversation, she reports significant weight fluctuation over her lifetime. She said she has been encouraged her to meet with a dietician to "learn how to eat healthily." She said she feels embarrassed to talk about it, and says it’s not a matter of knowledge – “I know what to do. I just can’t do it. I cannot control my eating.” She describes a pattern where she works hard to “get on track” with her eating but finds it difficult to maintain. She is 5’4”and reports she has had weight losses and gains in excess of 50 or more pounds multiple times. She has been treated for hypertension and high cholesterol for the last 5 years. What is your initial diagnostic impression?
What is Binge Eating Disorder?
Flat Affect, Alogia, Avolition/Anhedonia, Asociality, and Attentional Impairment are all common symptoms of what classification of disorders?
What are psychotic disorders?
A 63 year old male comes to your office at the request of his physician. He has been on pain medications for the past 20 years following a motor vehicle accident. His physician has begun weaning him off of the pain medications, as the man's liver and kidney function has been compromised from long term use. The man is angry, and unwilling to consider changing his current regiment, and is only here to prove to his doctor that he does not have a problem with his medications. He discloses that he has begun purchasing additional pills off the street to supplement his reduced supply, as his pain is so severe he cannot manage on the new dosing. He is openly sweating and shaking in your office, and says he has not had any medication in the last 48 hours because he's run out, and his prescription will not renew for another week. What is your initial diagnostic impression?
What is Mild Opioid Use Disorder?
A 28-year-old Caucasian woman reports she began drinking in high school, at age 15, and dropped out of college partway through her first year due to alcohol related attendance issues. She has re-enrolled twice since then but has been unsuccessful each time due to relapses. She reports multiple attempts to stop drinking, but has only been able to maintain sobriety for 2-4 weeks at a time. Whenever she tries to stop drinking, she gets nauseous, shaky, and disoriented. Within the last 4 months, she has withdrawn from her friends, feels sad almost every day, and has transient suicidal ideation. Her appetite has decreased, but her alcohol use has continued to increase, and she is currently consuming approximately half a “fifth” of vodka per day. She has frequent arguments with her parents, who are now threatening to cut her off financially because she spends most of her rent money on alcohol. She “can’t stop thinking about my next drink,” and reports feelings of guilt and worthlessness over being unable to stop drinking. What are your primary and secondary diagnostic impressions?
What are Severe Alcohol Use Disorder, and Moderate Major Depressive Disorder?
What are the five main principles of ethical practice?
What are: autonomy, beneficence, nonmaleficence, fidelity, and justice
The number of the following symptoms required for a diagnosis of a manic episode is ___.
-Inflated self-esteem or grandiosity
-Decreased need for sleep (e.g., feels rested after only 3 hours of sleep)
-More talkative than usual or pressure to keep talking
-Flight of ideas or subjective experience that thoughts are racing
-Distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli), as reported or observed
-Increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation (i.e., purposeless, non-goal-directed activity)
-Excessive involvement in activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments)
What are 3; 4 if the mood is only irritable?
Symptoms of schizophrenia that last for less than six months and cause no decline in impairment vs. a major mood disorder that occurs concurrently with psychotic symptoms and delusions/hallucinations for two or more weeks.
What is Schizophreniform Disorder vs. Schizoaffective disorder?
A 26-year-old woman who presents with a history of non-suicidal self-injury, specifically cutting her arms and legs, since adolescence. She has made two suicide attempts by overdosing on prescribed medications, one as a teenager and one six months ago; she also reports chronic suicidal ideation, explaining that it gives her relief to think about suicide as a “way out.” When she is stressed, she says that she often “zones out,” even in the middle of conversations or while at work. She states, “I don’t know who I am,” and describes a longstanding pattern of changing her hobbies, style of clothing, and sometimes even her job based on who is in her social group. At times, she thinks that her partner is “the best thing that’s ever happened to me” and will impulsively buy him lavish gifts, send caring text messages, and the like; however, at other times she admits to thinking “I can’t stand him,” and will ignore or lash out at him, including yelling or throwing things. Immediately after doing so, she reports feeling regret and panic at the thought of him leaving her. She also reports that before she began dating her current partner, she sometimes engaged in sexual activity with multiple people per week, often with partners whom she did not know. What is your initial diagnostic impression?
What is Borderline Personality Disorder?
A 41-year-old male was referred by his primary care physician after presenting to the Emergency Dept. with difficulty breathing. His physician was unable to find a medical explanation for his symptoms, which left him feeling confused, stressed, and angry. Over the last 6 months, he has had several instances where he felt an intense fear that would reach a peak within a few minutes. During these instances, he would also experience sweating, heart palpitations, chest pain and discomfort, and shortness of breath. At times, Dave worried that might die. As a result, Dave has persistent worry about having another attack. In addition, he has begun to avoid unfamiliar places and people where it may be difficult to get help in the event of another panic attack. The panic and associated avoidance are significantly impacting his life as he has been turning down social invitations, making excuses to stay at home whenever possible, and relying on his wife to drive their children to their various activities. Although she was understanding at first, his wife has grown frustrated with what she perceives as his irrational fear of panic attacks. These are the two most likely diagnoses.
What are Panic Disorder and Agoraphobia?
Robin Williams dropped out of this institution after three years (on a full scholarship), because the faculty told him they had nothing left to offer him.
What is Juilliard?